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COSMIN Risk of Bias tool to assess the quality of studies on reliability or measurement error of outcome measurement instruments: a Delphi study
Open accessPublished version of a preprint
Abstract
Background: Scores on an outcome measurement instrument depend on the type and settings of the instrument used, how instructions are given to patients, how professionals administer and score the instrument, etc. The impact of all these sources of variation on scores can be assessed in studies on reliability and measurement error, if properly designed and analyzed. The aim of this study was to develop standards to assess the quality of studies on reliability and measurement error of clinician-reported outcome measurement instruments, performance-based outcome measurement instrument, and laboratory values. Methods: We conducted a 3-round Delphi study involving 52 panelists. Results: Consensus was reached on how a comprehensive research question can be deduced from the design of a reliability study to determine how the results of a study inform us about the quality of the outcome measurement instrument at issue. Consensus was reached on components of outcome measurement instruments, i.e. the potential sources of variation. Next, we reached consensus on standards on design requirements ( n = 5), standards on preferred statistical methods for reliability ( n = 3) and measurement error ( n = 2), and their ratings on a four-point scale. There was one term for a component and one rating of one standard on which no consensus was reached, and therefore required a decision by the steering committee. Conclusion: We developed a tool that enables researchers with and without thorough knowledge on measurement properties to assess the quality of a study on reliability and measurement error of outcome measurement instruments.
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Head vs Screen-Mounted Eye Trackers: Comparisons Across Ethnic Diversity
Cade, A. E., Zoest, J., 美沙紀, 亀., Dukes, L., & Turnbull, P. (2026) · Current Eye Research · doi:10.1080/02713683.2026.2727290
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Bloch‐Nielsen, J. R., Schmidt, A., & Maribo, T. (2026) · European Journal of Physiotherapy · doi:10.1080/21679169.2026.2736258
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Standardising the Posterior Shoulder Endurance Test: A Narrative Review and Operational Framework
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“The RoB of each measure - ment property reported in an article was determined as the lowest rating of any standard in that criteria box (the worst-score-count method) (24,25).”
Utida, V. H. D. S., Silva, L. T., & Lopes, F. M. (2026) · Cadernos de Saúde Pública · doi:10.1590/0102-311xpt025126
HAZIR, A., Çil, E., Sönmez, Ö. F., & Başer, A. (2026) · Healthcare · doi:10.3390/healthcare14203399
Quality Assessment of Physician Discharge Summaries: Instrument Development and Reliability Study
Bentheim, L., Fehring, L., Friederichs, H., Alsofy, S. Z., & Unnewehr, M. (2026) · JMIR Formative Research · doi:10.2196/105705
“…Standards for the Selection of Health Measurement Instruments)–related methodological work emphasizes content validity and rigorous assessment of measurement properties, although COSMIN was originally developed mainly for health status and patient-reported outcome instruments [25-27].”
Warneke, K., Blazevich, A. J., Nunes, J. P., Gronwald, T., Clemente, F. M., Afonso, J. R., Andrade, R., Wallot, S., Sandig, D., Nimmerichter, A., et al. (2026) · European Journal of Applied Physiology · doi:10.1007/s00421-026-06435-y
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The COSMIN Clubs initiative: improving health measurement through collaborative learning
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“The solution: We discussed that the focus of the researchers was on only some of the components of the measurement (that is, assignment of the score ) [14 ], as the observations were based on videos in a lab/fixed environment, rather than on live clinical observations.”
Self-citationOutcome Measures in Dermatology
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Metadata
- Authors
- Mokkink, L. B., Boers, M., van der Vleuten, C. P. M., Bouter, L. M., Alonso, J., Patrick, D. L., de Vet, H. C. W., & Terwee, C. B.
- Affiliations
- Amsterdam Public Health (NL)
- Universitat Pompeu Fabra (ES)
- University of Washington (US)
- Corresponding author
- Mokkink, L. B.
- Venue
- BMC Medical Research Methodology
- Published
- 2020-12
- Volume
- 20
- Issue
- 1
- Pages
- 293-293
- ISSN
- 1471-2288 (ISSN-L)
- PMC
- PMC7712525
- OpenAlex
- W3107903990
- Cited by
- 588
- References
- 31
- Citations by year
- 2026: 106 · 2025: 121 · 2024: 149 · 2023: 101 · 2022: 72 · 2021: 37 · 2020: 2
- FWCI
- 32.32
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Medical Research Methodology (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by)
- VU Research Portal (publishedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion)
- Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion, cc-by)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (91617098)
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Reliability and Agreement in Measurement
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Keywords
- COSMIN, risk of bias, reliability statistics, measurement error, outcome measurement instruments, clinician-reported outcomes, performance-based outcome measures, laboratory parameters, study quality assessment, Delphi consensus, measurement properties
- MeSH terms
- Delphi Technique, Humans, Reproducibility of Results, Bias, Consensus
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